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Instructions for Completing FCC Form 508

Connect America Fund-Broadband Loop Support Mechanism Projected CAF-BLS Form

FCC Form 508 OMB Control No. 3060-0233

Estimated Average Burden Hours Per Response: 2.0 Hours

Instructions for Completing Connect America Fund-Broadband Loop Support Mechanism Projected Annual Cost and Revenue

FCC Form 508

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NOTICE: Section 54.903(a)(1) of the Federal Communications Commission's rules requires each rate-of-return incumbent telecommunications carrier that does not elect voluntary model-based support to provide information needed to calculate the projected annual cost and revenue data for each of its study areas in the upcoming funding year to USAC, the universal service Administrator. A rate-of-return carrier must submit this information on March 31st of each year, in order for the carrier to be eligible to receive Connect America Fund-Broadband Loop Support (CAF-BLS). This collection of information stems from the Commission's authority under Section 254 of the Communications Act of 1934, as amended, 47

U.S.C. §254. The data in the form will be used to calculate the amount of support, if any, that each reporting carrier is eligible to receive from the CAF-BLS mechanism.

We have estimated that each response to this collection of information will take, on average, 2.0 hours. Our estimate includes the time to read the instructions, look through existing records, gather and maintain the required data, and actually complete and review the form or response. If you have any comments on this estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0233), Washington, D.C. 20554. We also will accept your comments via the Internet if you send them to [email protected]. Please DO NOT SEND COMPLETED DATA COLLECTION FORMS TO THIS ADDRESS.

Remember -- You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid Office of Management and Budget (OMB) control number. This collection has been assigned an OMB control number of 3060-0986.

The Commission is authorized under the Communications Act of 1934, as amended, to collect the information we request in this form. We will use the information that you provide to determine CAF-BLS amounts. If we believe there may be a violation or potential violation of a statute or a Commission regulation, rule, or order, your form may be referred to the Federal, state, or local agency responsible for investigating, prosecuting, enforcing, or implementing the statute, rule, regulation, or order. In certain cases, the information in your form may be disclosed to the Department of Justice, court, or other adjudicative body when (a) the Commission; (b) any employee of the Commission; or (c) the United States government, is a party to a proceeding before the body or has an interest in the proceeding. In addition, information provided in or submitted with this form or in response to subsequent inquiries may also be subject to disclosure consistent with the Communications Act of 1934, FCC regulations, the Freedom of Information Act, 5

U.S.C. § 552, or other applicable law. Confidential treatment of the filed data may be requested in the cover letter by following the procedures set forth in Section 0.459 of the Commission’s rules, 47 C.F.R. § 0.459.

If you do not provide the information we request on this form, you are not eligible to receive support under the CAF-BLS mechanism, 47.C.F.R. § 54.903.

The foregoing Notice is required by the Paperwork Reduction Act of 1995, P.L. No. 104-13, 44 U.S.C. § 3501, et seq.

Specific Instructions

1. Introduction and Background.

In the MAG Order (FCC 01-304), the Federal Communications Commission (FCC) modified its rules to reform the interstate access charge and universal service support system for incumbent local exchange carriers (LECs) subject to rate-of-return regulation. In the Rate-of-Return Reform Order (FCC 16-33), the Federal Communications Commission (FCC) adopted technical rule changes to support the provision of broadband service to consumers in areas with high loop-related costs, without regard to whether the loops are also used for traditional voice services. Pursuant to 47

C.F.R. Sections 54.901-54.904, the FCC established the Connect America Fund-Broadband Loop Support (CAF BLS) mechanism. The FCC appointed the Universal Service Administrative Company (USAC) as Administrator of this universal service support mechanism.

2. The Carrier or the Carrier’s Agent May File This Form.

You may choose to complete FCC Form 508 and submit it to USAC. Alternatively, you may choose to designate an agent to file FCC Form 508 on your behalf. Please note that, if you choose to designate an agent to complete and submit FCC Form 508 on your behalf, an authorized officer or employee of your company must advise USAC of the identity of your agent and certify that the projected annual cost and revenue information provided to your authorized agent is accurate to the best of his/her knowledge. Your authorized agent must: (1) certify that he/she is authorized to submit the information on behalf of the reporting carrier; (2) certify that the ^{projected annual cost} and revenue requirement information provided on the form is based on data received from the reporting carrier; (3) certify that the information on the form is accurate to the best of the agent’s knowledge; and (4) provide copies of the projected annual common line revenue requirement and projected consumer broadband-only revenue requirement filing to the reporting carrier within 15 days. Specific instructions for complying with these steps are set forth below in Section VI. Certifications.

If a rate-of-return carrier elects voluntary model-based support pursuant to 47 C.F.R. section 54.311, it is not required to file this form.

3. When Must Each Rate-of-Return Incumbent Carrier File FCC Form 508, Projected CAF- BLS Form?

Carriers will be required to make an initial filing of Form 508 on a date to be announced by the Wireline Competition Bureau in accordance with the implementation of the CAF-BLS. Then, on March 31, 2017, and on that date each year thereafter, each rate-of-return incumbent carrier must file a projected CAF-BLS form setting forth its projections for the upcoming period, July 1 through June 30. 47 C.F.R. Section 54.903(a)(3).

After the March 31 deadline each year, any corrections to projected CAF-BLS and supporting data shall be made in the form of true-ups, using actual cost and revenue data that a carrier must report

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in FCC Form 509, Connect America Fund-Broadband Loop Support Actual Cost and Revenue Data Collection Form.

4. Specific Instructions for Completing This Form.

You should complete this worksheet in order to submit your projected CAF-BLS information that is due on March 31 of each year.

Block 1 - Contact Information.

Row 1, Carrier Study Area Code: Provide your six-digit numerical code assigned by the National Exchange Carrier Association (NECA) for the study area in which you serve.

Row 2, Carrier Study Area Name: Provide the standard name that you use to identify your study area.

Row 3, Service Provider Identification Number: Provide the nine-digit Service Provider Identification Number (SPIN) that USAC has assigned to you. If you do not know your SPIN, please contact the HCLI Customer Service Center for assistance. Contact information for the HCLI Customer Service Center can be found in Section IX of these instructions.

Row 4, Data Period: Provide the month, day, and year of the start date and end date for the period for which you have reported information in this form. For example, you would enter 07/01/2017 - 6/30/2018 for the projected annual costs and revenues that you report on March 31, 2017.

Row 5, Submission Date: Provide the month, day, and year of the submission date of the form. The initial submission of the projected CAF-BLS information is due on a date to be announced by the Wireline Competition Bureau, and then on March 31, 2017 and on that date each year thereafter.

Row 6, Contact Name: Provide the name of the person that USAC should contact to discuss any questions concerning the information that you submitted in this form.

Row 7, Contact Telephone Number: Provide the telephone number (including area code) of the person that you identified in Row 6.

Row 8, Contact E-Mail Address: Provide the e-mail address of the person that you identified in Row 6.

Block 2-Projected CAF-BLS by Study Area.

Row 9, Projected Annual Common Line Requirement: Provide your projected annual Common Line Revenue Requirement in dollars, as defined in Part 69 of the FCC’s rules, for the reporting period.

Row 10, Projected Consumer Broadband-Only Loop Revenue Requirement: Provide your projected

Consumer Broadband-only Loop Revenue Requirement in dollars in accordance with Part 69 of the FCC’s rules, for the reporting period.

Row 11, SLC Revenues: Provide your projected amount of Subscriber Line Charge (SLC) revenues in dollars for the reporting period. 47 C.F.R. Sections 69.104(n) and 69.104(o).

Row 12a, Forecasted Average Monthly Consumer Broadband-only Loops: Provide your forecasted number of Average Monthly Consumer Broadband-only Loops for the reporting period. 47 C.F.R Section 69.132.

Row 12b, Imputed Consumer Broadband-only Revenues: Provide your Imputed Consumer Broadband-only Revenues by multiplying your Forecasted Average Monthly Consumer Broadband- only Loops by 12 and by a revenue imputation of $42. 47 C.F.R. Section 54.901(a)(2).

Row 12, Projected Consumer Broadband-Only Loop Revenues: Provide your projected amount of Consumer Broadband-Only Loop Revenue in dollars for the reporting period. 47 C.F.R. Section 54.901(a) (2). This is to be calculated as the lesser of $42 per loop per month or the Consumer Broadband-only Loop Revenue Requirement. Enter the lesser of Row 10 or Row 12b.

Row 13, Special Access Surcharge Revenues: Provide your total projected amount of special access surcharge revenues in dollars for the reporting period. 47 C.F.R. Section 69.115.

Row 14, Line Port Costs In Excess Of Basic Analog Service: Provide your total projected amount of line port costs in excess of basic analog service revenue in dollars for the reporting period.

47C.F.R. Section 69.130.

The above projected revenue forecast data should not reflect the application of the budgetary constraint. 47. C.F.R. Section 54.901(f). Once the budget control mechanism is applied to forecasted disbursements, the Administrator will publish post-budget constraint Connect America Fund Broadband Loop Support on May 1^st each year.

5. Certifications.

You must submit certifications with the signature of an authorized person with the FCC Form 508. If you are filing FCC Form 508 on your own behalf, you must complete the reporting carrier certification page. If you are authorizing an agent to file FCC Form 508 on your behalf, on the other hand, you must complete the top portion of the agent certification page. Once you have completed the top portion of the agent certification page, your authorized agent must complete the bottom portion of the agent certification page.

Carriers submitting FCC Form 508 on their own behalf. If you are filing FCC Form 508 on your own behalf, an authorized officer or employee of your company must complete the reporting carrier certification page of FCC Form 508. By completing the reporting carrier certification page, the officer or employee of the reporting carrier is certifying that: (1) he/she is an officer or an employee of the reporting carrier; (2) his/her responsibilities include ensuring the accuracy of the projected

cost and revenue information reported on the form; (3) the cost data is compliant with the

Commission's cost allocation rules and does not reflect duplicative assignment of costs to the consumer broadband-only loop and special access categories; and (4) the information reported on the form is accurate to the best of his/her knowledge. The certification must be signed by an authorized officer or employee of the company and must be submitted to USAC along with the projected CAF-BLS data.

Carriers authorizing an agent to file FCC Form 508 on their behalf. If you are authorizing an agent to file FCC Form 508 on your behalf, you, as the reporting carrier, must complete the top portion of the agent certification page of FCC Form 508. By completing the agent authorization section, the officer or employee of your company is certifying that: (1) the agent identified on the agent certification is authorized to submit the projected annual cost and revenue information to USAC on your behalf; (2) he/she is an officer or employee of the reporting carrier; (3) his/her responsibilities include ensuring the accuracy of the projected annual cost and revenue requirement information provided to the authorized agent; the cost data is compliant with the Commission's cost allocation rules and does not reflect duplicative assignment of costs to the consumer broadband-only loop and special access categories; and (4) the projected annual cost and revenue information provided to the authorized agent is accurate to the best of his/her knowledge. The certification must be signed by an authorized officer or employee of the company. You will then provide the certification with the signature of the authorized person to your authorized agent.

Your authorized agent is responsible for completing the bottom portion of the agent certification page of FCC Form 508. By completing the agent certification section, the authorized agent is certifying that: (1) he/she is authorized to submit the information on your behalf; (2) the projected annual cost and revenue information provided on the form is based on data received from you (the reporting carrier); (3) the information provided on the form is accurate to the best of the agent’s knowledge; (4) the cost data is compliant with the Commission's cost allocation rules and does not reflect duplicative assignment of costs to the consumer broadband-only loop and special access categories; and (5) the authorized agent will provide copies of the projected Connect America Fund Broadband Loop Support filing to you within 15 days. The certification must be signed by the authorized agent or an employee of the authorized agent.

Certifications with the signatures of the authorized persons, as well as all of the information requested on the worksheet of FCC Form 508 for all incumbent rate-of-return carriers, must be received by USAC in accordance with the filing dates on page 2 of these instructions. Please remember that, if the form is submitted electronically via email at [email protected] in Excel 97 or above, the certifications with the signatures of the authorized persons still must be received by USAC by the due dates.

1. Request for Confidential Treatment of Filed Data.

You may request confidential treatment of some or all of the data filed to qualify for C A F B LS by making such a request in your cover letter transmittal of your FCC Form 508 and by complying with the requirements set forth in 47 C.F.R. Section 0.459.

2. Where to File Completed Forms.

You are encouraged to submit the form electronically via email at [email protected]. The form must be received at the address listed below by the due date. If you are unable to submit the completed form in electronic format, please submit your paper copies to the same address.

U.S. Mail, Overnight, or Expedited Mail/Courier Services: USAC

Customer Operations

700 12^th Street, NW

Suite 900

Washington, DC 20005

(844) 357-0408

3. If You Have Questions.

Please consult the USAC Web site, ^{https://www.usac.org/hc/} for important information and updates.

You may submit questions via e-mail to [email protected]

You may telephone USAC’s HC Customer Service Center at (844) 357-0408 (toll-free).

When submitting any inquiry to USAC’s HC Customer Service Center, whether by telephone or e-mail , please provide the name of the person submitting the inquiry and the company on whose behalf the inquiry is submitted, the person’s telephone number, e-mail address, and please describe your inquiry as specifically as possible.

Revised January 2023